Publication year
2014
Citation Title
Measuring secondary traumatic stress symptoms in military spouses with the posttraumatic stress disorder checklist military version.
Journal Name
The Journal of Nervous and Mental Disease
Journal Volume
202
Issue Number
12
Page Numbers
864-869
DOI
10.1097/NMD.0000000000000213
Summary
People who experience trauma can transmit traumatic stress symptoms to those close to them which is referred to as secondary traumatic stress. This study examined National Guard Veterans who had been deployed at least once and their spouses to determine the rate at which secondary traumatic stress might be occurring in this population, and whether traumatic stress appeared to be transmitted from Service members to their spouses.
Key Findings
Approximately 6% of the Veterans and approximately 5% of the spouses in this study appeared likely to have posttraumatic stress disorder (PTSD); however, only one of the Veteran-spouse pairs both qualified for PTSD based on the study measure.
Approximately half of the Veterans in the study were positive for all of the hyperarousal symptoms of PTSD, including trouble falling or staying asleep (45%), feeling jumpy or easily startled (50%), difficulties concentrating (56%), feeling "super alert" (56%), feeling irritable or having angry outbursts (65%). Fifty-one percent also reported feeling distant or cut off from other people.
More than 60% of spouses reported no symptoms. The most commonly endorsed item was feeling irritable or having angry outbursts (37%).
As rates of Veteran posttraumatic stress increased, rates of spouse secondary stress increased.
Implications for Program Leaders
Provide education to military couples regarding the possibility of transmission of traumatic stress symptoms in the relationship
Offer workshops for couples during reintegration to increase couples' resilience to PTSD symptoms
Disseminate information regarding possible PTSD symptoms and resources for Service members and their families who are managing them
Implications for Policy Makers
Promote the incorporation of spouses in PTSD education workshops and seminars that are designed for Service members
Recommend partnerships among DoD programs and community-based programs who serve National Guard Service members to improve access to and awareness about services for those with PTSD
Recommend professional education for those working with military couples to assess for secondary trauma symptoms in spouses
Methods
The researchers invited all Army National Guard Veterans and spouses in an undisclosed U.S. state to participate via mail, with a response rate of 15% (1,493 possible participants with 227 responding).
The questionnaire packet was organized by the Family Readiness Program.
Data were gathered through separate self-report questionnaires for the Veteran and spouse, with a previously validated questionnaire being modified for use by spouses.
Participants
Participants included 227 heterosexual couples with one spouse who was a Veteran of the Army National Guard (218 male and nine female Veterans). Participant ranks included 6% enlisted, 67% non-commissioned officers, 19% officers, and 5% warrant officers.
Veterans (93% White) averaged 37 years old and spouses averaged 36 years old (8% White). No other race/ethnicity data were provided. Participants were married an average of 11 years with 11% reporting no children, 53% reporting 1-2 children, and 37% reporting three or more children.
On average, Veterans had returned from deployment 3.5 years ago: 76% returned from Iraq, 14% from Afghanistan, and 10% from elsewhere. Number of deployments ranged from one (67%) to two (27%), to three or more (7%).
Limitations
Inconsistent use of the terms "Veteran" and "Soldier" made it unclear whether or not the Soldiers that were surveyed were separated from the Army National Guard.
The researchers modified a questionnaire used for Service members to measure spouse PTSD symptoms and did not provide reliability or validity data for this modified questionnaire.
The low response rate of 15% makes it difficult to generalize this study to the larger National Guard population, as it is unclear if or how the responders and non-responders differed.
The researchers did not control for previous trauma, so it was unclear when symptoms were reported whether they were related to military experiences or unrelated trauma.
Avenues for Future Research
Complete validity and reliability procedures with the PTSD questionnaire modified for use with military spouses
Replicate the study while controlling for previous trauma through additional measures
Examine traumatic stress in Soldiers and their spouses at an earlier time point than 3.5 years after returning from deployment
Focus
National Guard
Target Population
Population Focus
Military Branch
Military Component
Abstract
Little research to date has examined secondary traumatic stress symptoms in spouses of military veterans. This study investigated the presence and severity of posttraumatic stress symptoms in a sample of 227 Army National Guard veterans and secondary traumatic stress symptoms among their spouses. The veterans completed the posttraumatic stress disorder (PTSD) Checklist Military Version (PCL-M) (Weathers et al., 1993) to determine the probable prevalence rate of posttraumatic stress symptoms. A modified version of the PCL-M was used to assess secondary traumatic stress symptoms in the spouses. A confirmatory factor analysis showed that the modified version of the PCL-M used to assess secondary traumatic stress symptoms in spouses fits using the same four-factor PTSD structure as the PCL-Mfor veterans. This study provides initial evidence on the underlying symptom structure of secondary traumatic stress symptoms among spouses of traumatic event victims.
Abstract Document
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